Advanced Search

Anesthesia Coding Alert

READER QUESTIONS:

Discuss Whether 52 Applies to AICD Case

Published on Thu Oct 13, 2005

Question: What anesthesia code should I report for an automatic implantable cardioverter/defibrillator (AICD) check? 


Nebraska Subscriber
 

Answer: For the automatic implantable cardioverter/defibrillator check, the surgeon probably reported 93642 (Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator [includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parameters]).

Code 00537 (Anesthesia for cardiac electrophysiologic procedures including radiofrequency ablation) is the anesthesia cross-code. Some coders believe its 10 base unit value is too high for the service rendered, so they append modifier 52 (Reduced services) and include notes explaining the anesthesiologist's work.
 
Other coders believe the anesthesiologist's risk in caring for a patient with arrhythmia justifies the high unit value. Talk with your anesthesiologist to determine what services he provided and whether appending modifier 52 is appropriate for the procedure.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Anesthesia Coding Alert

View All